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Throughput analysis of trauma resuscitations with financial impact
E R Imami1, F W Clevenger, S D Lampard
1Department of Surgery, University of Florida Health Science Center/Jacksonville 32209-6511, USA.
Objectives:
In an era of diminishing reimbursement, efficient resource utilization is paramount. The effects of three parallel factors were tracked: (a) coordinated physician-hospital patient care, (b) increasing physician awareness of resources, and (c) in-house trauma attendings.
Design:
Observational study.
Methods:
A Windows-based database application was made to track all resuscitations at a Level I adult/pediatric trauma center. Time data were immediately entered upon discharge from the resuscitation bay, and further data (Injury Severity Score, length of stay, and mortality) were obtained by linking to a concurrent trauma registry. Group I was a 6-month control. Group II reflects factors a and b, and group III adds factor c, each contributing 3 months of additional data. Statistical comparisons were made using analysis of variance and Fisher's exact test.
Results:
There were 2,546 resuscitations with 1,201, 636, and 709 in groups I, II, and III, respectively. The five most frequent dispositions, resuscitation times, and hospital costs were analyzed.
Conclusions:
Given similar patient groups, factors a and b together and factor c improved throughput in the resuscitation bay by approximately 35% (5-133 min) each. Hospital costs concurrently decreased with no rise in mortality.